Raturi S, et al. – This study focused on the nutritional intake and growth velocity (GV) in extremely low–birth–weight (ELBW) infants in Asia. Investigations revealed that GV at discharge was positively associated with increased protein and energy intake in the first 28 days and adversely affected by the presence of neonatal morbidities. A strong evidence of extra–uterine growth restriction was observed in the majority of preterm ELBW infants with lower z scores at discharge compared to at birth.

Methods

• This prospective study was performed to evaluate total protein and energy intake for week 1, days 14, 21 and 28 of life.
• By measuring GV using an exponential model, post–natal growth was calculated.
• To identify the potential risk factors associated with poor GV at day 28 and at discharge from hospital, univariable analysis was used.

Results

• The median GV from birth to day 28 was 9.84 g/kg/day and 11.87 g/kg/day for GV from birth to discharge.
• At discharge, increased protein and energy intake was associated with higher GV.
• Hypotension needing inotropes, necrotising enterocolitis (NEC), patent ductus arteriosus and chronic lung disease were significantly associated with reduced GV at discharge.
• Infants with NEC, hypotension needing inotropes and sepsis took a significantly longer time to achieve full enteral nutrition.
• A longer time to attain full enteral feeds was associated with slower GV at discharge.
• Findings displayed that small–for–gestational–age babies increased from 22% at birth to 66.6% at discharge.